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. 2024 Jun;205(3):545-554.
doi: 10.1007/s10549-024-07261-6. Epub 2024 Mar 12.

Immediate and delayed risk of breast cancer associated with classic lobular carcinoma in situ and its variants

Hannah L Chung  1 , Lavinia P Middleton  2 , Jia Sun  3 , Gary J Whitman  4
Affiliations

Immediate and delayed risk of breast cancer associated with classic lobular carcinoma in situ and its variants

Hannah L Chung et al. Breast Cancer Res Treat. 2024 Jun.

Abstract

Objective: To determine the risk of breast cancer due to lobular carcinoma in situ (LCIS).

Methods: This retrospective IRB-approved study identified cases of LCIS after percutaneous breast biopsy from 7/2005 to 7/2022. Excluded were cases with less than 2 years of imaging surveillance or a concurrent ipsilateral breast cancer diagnosis within 6 months of the LCIS diagnosis. Final outcomes of cancer versus no cancer were determined by pathology at surgical excision or the absence of cancer on imaging surveillance.

Results: A total of 116 LCIS lesions were identified. The primary imaging findings targeted for percutaneous biopsy included calcifications (50.0%, 58/116), MR enhancing lesions (25.0%, 29/116), noncalcified mammographic architectural distortions (10.3%, 12/116), or masses (14.7%, 17/116). Surgical excision was performed in 49.1% (57/116) and imaging surveillance was performed in 50.9% (59/116) of LCIS cases. There were 22 cancers of which 11 cancers were discovered at immediate excision [19.3% (11/57) immediate upgrade] and 11 cancers developed later while on imaging surveillance [18.6% (11/59) delayed risk for cancer]. Among all 22 cancers, 63.6% (14/22) occurred at the site of LCIS (11 at immediate excision and 3 at surveillance) and 36.4% (8/22) occurred at a location away from the site of LCIS (6 in a different quadrant and 2 in the contralateral breast).

Conclusion: LCIS has both an immediate risk (19.3%) and a delayed risk (18.6%) for cancer with 90.9% occurring in the ipsilateral breast (63.6% at and 27.3% away from the site of LCIS) and 9.1% occurring in the contralateral breast.

Keywords: Cancer; Florid; Lobular carcinoma in situ; Pleomorphic; Variant.

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